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The Three Phases of Shingles

RM Shingles


When you were a child, you probably asked your parents or guardian what life was like when they were children – and chances are they probably told you that life was much different. Now as an adult, that distinction becomes clear that times certainly do change as we get older, and you need not have children to notice, but rather just look around. From music to fashion, from entertainment to technology, the world is constantly changing from generation to the next.

However, one thing that has always remained true is that children get sick, and no ailment is regarded as almost a rite of passage as chickenpox. And while true, the problem lies in the assumption that once chickenpox is had, then it is over and done with. Sadly, this misconception can prove to be a painful realization for many adults later on in life.

Shingles is a mutant variety of the chickenpox virus and is one that can cause numerous complications, especially in the elderly. Prior to the varicella vaccine being introduced, chickenpox was considered a relatively universal experience, one that most children experienced with little to no threat to one’s general health or well-being. What most people don’t realize though is that this common childhood illness can have long and far-reaching consequences to a person’s health throughout their lives.

“Regardless of when you contract chickenpox (either as an adult or a child), the Varicella Zoster Virus (VZV) that causes the disease can stay dormant in your body for years,” says Dr. Sai Kishore, intensivist, and pulmonologist at the KL Multispecialty Hospital and St Isabel’s Hospital in Chennai. “The virus is reactivated when you experience a period of weakened immunity. It’s like a dormant volcano that eventually erupts.”

While there are many theories as to why the VZV virus becomes reactivated in the body including stress and other ailments, the fact remains that doctors are not exactly sure why. However, doctors do know that when shingles are present, it does progress with three distinct phases.

According to Dr. Kishore, “In the earliest pre-emptive phase, the patient will feel a sensation of itchiness and pain along the nerves. Your eye or throat might be infected, accompanied by increasing fatigue.” A diagnosis at this stage is hard because pain is the predominant symptom.

The second phase is known as the eruptive phase, which is when crops of white boils filled with fluid begin to appear. This often accompanied by a fever and unlike chickenpox, shingles related rashes are restricted to one side of the body.

“The shingles virus lies dormant in the areas of your body where your nerves gather in a bundle—called multiple dorsal root ganglia. It’s usually found in the nerves of your spinal cord or in your cranium (skull),” says Dr. Kishore. “When the virus is reactivated in these nerve clusters, it only affects the skin along these nerves.”

The third and final phase of shingles, however, is where most of the problems arise. Known as Postherpetic Neuralgia, this phase begins usually three months after the boils crust over and is characterized by intolerable pain that can last for months and in some cases years.
Thankfully, not everyone with shingles will experience the Postherpetic Neuralgia stage, especially if treated early.

If you or someone you know suspects they might have shingles, we advise you to visit your doctor immediately to discuss treatment options.